New Treatments for Urticaria (Hives)

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Urticaria is a distressing skin condition commonly known as hives. Chronic urticaria is the occurrence of skin wheals daily or almost daily for six weeks or more. Antihistamines are the first-line treatment, but they do not work for all cases. Corticosteriods are effective for many, but the side effects are a problem for long-term use. Dr. Christine Boubouka and coworkers at the University of Athens, Greece, reported that cyclosporin A may be better for some patients with severe urticaria.

Chronic urticaria can be caused by physical factors, drugs, foods, additives, infections, parasites, inhaled allergens, systemic autoimmune diseases, or psychological stress, Boubouka explained. However, in the majority of cases, a specific cause can not be identified. Autoimmune processes are commonly involved. Patients with a positive autologous serum skin test (ASST) are most likely to have severe disease that does not respond to antihistamines.

In Boubouka's study, 25 women and five men with urticaria were treated with cyclorsporin A. The starting dose was 1.5 to 2.5 mg/kg, and the dosage was decreased each month as symptoms improved. The improvement rates were 31 percent after one month, 46 percent after two months, 71 percent after three months, 87 percent after four months, and 88 percent after five months. The authors recommended a larger study with a randomized, controlled protocol.

Dr. Becky M. Vonakis and coauthor Dr. Sarbjit S. Saini at Johns Hopkins University School of Medicine in Baltimore, Maryland, provided a review of chronic urticaria. They reported that leukotriene receptor antagonists, sulfasalazine, mycophenolate, and dapsone have also been tried with some success. These authors estimated that up to 25 percent of the United States population experiences urticaria at some time. Many of these cases clear up in less than six weeks, but one fifth of the chronic cases persist for more than five years.

Dr. Mona Al-Ahmad of Kuwait reported that the asthma medication omalizumab (Xolair) was effective in treating three patients with urticaria that did not respond to antihistamines, leukotriene receptor antagonist, or corticosteroid treatment.

I found 151 clinical trials currently listed at http://clinicaltrials.gov. Check with your doctor if you are interested in participating.

References:

Boubouka C et al, “Treatment of autoimmune urticaria with low-dose cyclosporin A: a one-year follow-up”, Acta Derm Venereol 2011; 91: 50-54. http://www.ncbi.nlm.nih.gov/pubmed/21264453

Vonakis BM et al, “New concepts in chronic urticaria”, Curr Opin Immunol. 2008 December; 20(6): 709-16. http://www.ncbi.nlm.nih.gov/pubmed/18832031

Al-Ahmad M, “Omalizumab therapy in three patients with chronic autoimmune urticaria”, Ann Saudi Med. 2010 Nov-Dec; 30(6): 478-81. http://www.ncbi.nlm.nih.gov/pubmed/20864790

Reviewed May 31, 2011
Edited by Alison Stanton

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.